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Moving it to Another Level

This morning I wake early to review and amend the sample material I need to send to a literary agent, seeking representation for my book and I find myself dedicating it to Dean’s memory.

Earlier this week I was present with Dean’s family at the inquest into his death. I suppose one has to say the event gave a reasonable answer to the question asked by the family – why did Dean die?

After the Coroner’s verdict on the causes of Dean’s death, we were all left with a sense of disquiet, frustration, and yes, anger. The disquiet comes from the knowledge that the inquest is concerned with little more than a 24-hour snapshot of 14-years of being ‘captured’ in the underworld of psychiatry and the abuses that can go on there. I got a sense of that from the very short time – less than six months – that I found myself alongside Dean in a place that quite frankly felt menacing at times.

With terrible prescience Dean had once said that the only way he would escape his confinement in the dungeons of the mental health service would be in a body bag.

A clinical psychologist who is leaving the NHS after 18 years of working inside, wants now to work outside it to ‘promote more emancipatory’ approaches to mental health, expresses my underlying disquiet about what I call the underworld of psychiatry:

How do we escape the confinements of the asylum mentality? The asylum was all about the exclusion and control of those people not mentally in tune enough with society’s values, even if they hadn’t broken any law.

…If you categorize someone with a psychiatric diagnosis it can become a way of trying to control them and shape how they think about themselves. Then we have the heavy-handed use of psychotropic drugs; not just to give someone a temporary break from their difficulties, but for those in power to promote the long-term suppression of challenging thoughts and emotions with the latest profit-making pharmaceutical product.[1]

I am reminded of the time when I acted in the role of advocate on behalf of a client whose psychiatrist had said ‘I won’t section you this time’. When would it be 'that' time? Would there be prior notice of when the anti-psychotic drenched hand would fall or would it be sudden without warning? It was a distinct threat, not founded on any solid, irrefutable evidence that this person was a danger to self or others. The fear this arouses is unimaginable.

This particular Dr Bedlam was simply demonstrating that he had ultimate power over my client; and he was abusing that power. Unfortunately he had left himself exposed to a legitimate charge of ‘unprofessional conduct’ in his dealings with my client, because he had previously sought to avail himself of her professional connections for personal advantage. We were able to ‘fix’ him on the spot right there and then. The upshot was in order to safeguard his position the psychiatrist promptly discharged my client! Now that is beyond unprofessional.

My frustration at the inquest came from the awareness that Dean’s Dr Bedlam – an apparently reasonable, mild-mannered man on the surface – did not tell the truth, the whole truth and nothing but the truth; neither did the sour-faced Miss Gradgrind[2], a senior manager with the private company responsible for the ‘managed accommodation’ where Dean was resident. Only Dean's key worker had the decency to express his condolences to the family from the witness box.

She did not have the courtesy to acknowledge the family, not even by mere eye contact. It was possible for the family’s legal representative to probe the discrepancies in the Gradgrind story to reveal, as the Coroner pointed out, that she had evaded the ‘whole’ truth by omission.

Unfortunately, the same could not be done to Dr Bedlam simply because the procedure in a coroner’s court is investigative not inquisitorial, and his lawyer was already jumping up at intervals with some spurious defensive statement as deflection.

Bedlam's ever so slightly misleading statements and downright half truths were designed to disguise and brush aside the fact that Dean had begun to experience some very serious side-effects from one particular antipsychotic drug he was forced to take over the last few years, and which the pathologist could not categorically deny may have had a role in the ‘multi-factorial’ reasons given for his death.

The surprised expression on Bedlam’s face was apparent when the family indicated to the Coroner, following her questioning, that there was nothing more they wished to hear from him. Bedlam had initially ignored two invitations from the Coroner’s office to attend the inquest but promptly responded at the possibility of facing a subpoena.

All of that left the family with a sense of injustice about what had been swept under the carpet, and the difficulty and probably impossibility, in probing deeper, in order to hold the ‘system’ accountable through civil action, for aspects of Dean’s experience and treatment in the underworld of psychiatry.

I was intent on sending Bedlam a scathing letter designed to puncture his supercilious, self-righteous smugness. How was his constant description of Dean as ‘grandiose’ a contribution to explaining his sudden and unexplained death? And what crass insensitivity towards a family in mourning.

After distancing myself from the inquest for a few days, I can hear the old monk, my former spiritual mentor saying ‘you live in a world of duality but don't have to engage with either/or scenarios. There is always a middle way. How can you know the purpose for which Dean’s soul incarnated in the physical world this time? If you have a role to play here, then you will know what to do; until then do nothing’.

I've decided that I am too ready to jump into the arena and have a fight, when it is not really my battle. I need to step back. Perhaps Bedlam’s path and mine will cross at another time in another place, for a different purpose. For now, I can move it all to another level and be content.